Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes - The Fremantle diabetes study
Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes - The Fremantle diabetes study
复制标题
DOI：
10.2337/diacare.27.3.752
复制
发表时间：
2004-03-01
期刊：
影响因子：
16.2
通讯作者：
Davis, TME
中科院分区：
文献类型：
--
作者：
Davis, WA;Knuiman, M;Davis, TME
目的：前瞻性地研究糖尿病、血糖控制和肺活量测定之间的关系。研究设计和方法：基于社区的队列研究，1993年至1994年间，495名无肺部疾病史的欧洲裔2型糖尿病患者接受了基线肺活量测定。125名患者的亚组在平均7.0年后被重新研究。主要结局指标包括用力肺活量（FVC）、1s用力呼气量（FEV1）、肺活量（VC）和经体温、气压和水饱和度校正的呼气峰流量（PEF），并以绝对值或年龄、性别和身高的百分比预测值表示。结果：在125名前瞻性研究的患者中，每项肺活量测量的平均百分比预测值在基线时下降了10%，而FVC、FEV1、VC和PEF的绝对测量值分别以每年68、71和84 ml的速度和17 l/min的速度继续下降。较差的血糖控制一致预测肺功能的下降，其表现形式为较高的更新平均HbA（1c）、随访HbA（1c）或随访空腹血糖。在Cox比例风险模型中，FEV1百分比预测值下降是全因死亡率的独立预测因子。结论：肺容量减少和气流受限可能是2型糖尿病的慢性并发症，其严重程度与血糖暴露有关。在调整了其他已知的危险因素后，气流限制是2型糖尿病患者死亡的预测因子。
OBJECTIVE- To examine prospectively the relationship between diabetes, glycemic control, and spirometric measures. RESEARCH DESIGN ANDMETHODS- From a community-based cohort, 495 Europid (i.e., of European descent) patients with type 2 diabetes who had no history of pulmonary disease underwent baseline spirometry between 1993 and 1994. A subset of 125 patients was restudied a mean of 7.0 years later. The main outcome measures included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), vital capacity (VC), and peak expiratory flow (PEF) corrected for body temperature, air pressure, and water saturation and were expressed either in absolute terms or as percentage-predicted value for age, sex, and height.RESULTS- Mean percentage-predicted values of each spirometric measure were decreased > 10% in the whole cohort at baseline and absolute measures continued to decline at an annual rate of 68, 71, and 84 ml/year and 17 l/min for FVC, FEV1, VC, and PEF, respectively, in the 125 prospectively studied patients. Declining lung function measures were consistently predicted by poor glycemic control in the form of a higher updated mean HbA(1c), follow-up HbA(1c), or follow-up fasting plasma glucose. In a Cox proportional hazards model, decreased FEV1 percentage-predicted value was an independent predictor of all-cause mortality.CONCLUSIONS- Reduced lung volumes and airflow limitation are likely to be chronic complications of type 2 diabetes, the severity of which relates to glycemic exposure. Airflow limitation is a predictor of death in type 2 diabetes after adjusting for other recognized risk factors.